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Dental services lack a coherent strategy

9 January 2019

The BDA has expressed disappointment that despite a heavily trailed focus on both primary care and prevention, the government has failed to outline a coherent strategy for dental services within its 136-page NHS 10 Year Plan.

The Plan makes reference to supporting dental services via its Starting Well initiative, claiming it supports 24,000 dentists across England to "see more children from a young age to form good oral health". In reality the programme is not receiving any new investment, and is active in a handful of wards in just 13 English local authorities. References are also made to addressing oral health needs of care home residents and children with learning difficulties.

The PM launched her plan in Liverpool's famed Alder Hey paediatric hospital. Tooth decay remains the number one reason for child hospital admissions, with official data showing that in Liverpool alone 4,000 children have undergone hospital extractions in the last 5 years, costing up to £1 million a year. There were 45,077 extractions of multiple teeth in under-18s across England in 2017/18 at a cost of £38.9 million, according to NHS spending data. No children in Merseyside will currently benefit from the government scheme.

Since taking office Health Secretary Matt Hancock has consistently pledged to put prevention at the heart of NHS strategy – but has failed to invest in public health activity or make any tangible commitment to dentistry. The Westminster Government's spend per head on NHS dentistry has fallen by £4.95, from £40.95 to £36, in the last five years. Academic research has pointed to significant pressures placed on both GP and A&E services, in part thanks to NHS charges pushing large volumes of dental patients to other parts of the health system.

The plan also failed to address the NHS's workforce issues, including the growing recruitment and retention crisis in the dentistry, fuelled by the discredited NHS dental contract. The system based on hitting tough activity targets for curative treatment, has helped fuel access issues across England and has stifled prevention. BDA surveys have estimated that 65% of practices who tried recruiting in 2017 experienced difficulties filling vacancies, leaving patients without access to NHS care.

"The Prime Minister launched her strategy at a paediatric hospital, serving a city that spends £1 million a year extracting rotten teeth from children. We have faced year on year cuts, a recruitment and retention crisis, and have patients travelling over 50 miles to secure access to basic services. Now a single unfunded scheme is being offered as a substitute for proper resources and a coherent plan.

"If government really intends to put the mouth back in the body they need to work with this profession on implementation. The alternative is to keep treating dentistry as an afterthought, and let the NHS pay the price."